中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (39): 7295-7298.doi: 10.3969/j.issn.1673-8225.2011.39.019

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

不稳定Hangman骨折颈椎前后路融合金属植入物内固定方式的对比

张  沛,刘  斌,吴一民,贺永雄,常志强,祝  勇,于宝龙   

  1. 内蒙古医学院第二附属医院颈椎外科,内蒙古自治区呼和浩特市010030
  • 收稿日期:2011-06-01 修回日期:2011-07-08 出版日期:2011-09-24
  • 作者简介:张沛★,男,1966年生,河南省清丰县人,2008年内蒙古医学院毕业,硕士,副主任医师,副教授,硕士生导师,主要从事颈椎外科及脊髓损伤修复研究。 zhangpei1966@sina.com

Comparison of anterior and posterior operation treatment for Hangman's fracture

Zhang Pei, Liu Bin, Wu Yi-min, He Yong-xiong, Chang Zhi-qiang, Zhu Yong, Yu Bao-long   

  1. Department of Cervical Surgery, Second Affiliated Hospital of Inner Mongolia Medical College, Hohhot  010030, Inner Mongolia Autonomous Region, China
  • Received:2011-06-01 Revised:2011-07-08 Online:2011-09-24
  • About author:Zhang Pei★, Master, Associate chief physician, Associate professor, Master’s supervisor, Department of Cervical Surgery, Second Affiliated Hospital of Inner Mongolia Medical College, Hohhot 010030, Inner Mongolia Autonomous Region, China zhangpei1966@sina.com

摘要:

背景:对于Hangman骨折,采用颈前路融合钢板置入内固定和后路C2椎弓根、C3侧块钉棒置入内固定,目前存在争议。
目的:比较颈前路融合钢板置入内固定和后路C2椎弓根、C3侧块钉棒置入内固定治疗Hangman骨折的临床效果。
方法:将26例Hangman骨折患者按随机数字表法分为2组,分别行颈前路减压植骨钛合金钢板置入内固定与后路C2椎弓根、C3侧块钉棒置入内固定治疗。
结果与结论:与后路C2椎弓根、C3侧块钉棒置入内固定治疗比较,颈前路减压植骨钛合金钢板置入内固定治疗手术时间更短,术中出血与术后引流量更少(P < 0.05)。两组术中、术后并发症差异无显著性意义。提示与颈椎后路手术内固定相比,颈椎前路融合植入物内固定手术治疗Hangman骨折手术时间短,术中出血量少,术后颈椎功能恢复良好。

关键词: 枢椎, 颈椎骨折, 前路融合, 后路融合, 内固定

Abstract:

BACKGROUND: Posterior C2-3 pedicle screws fixation have been used in internal fixation of Hangman’s fracture. C2-3 anterior fusion and plate fixation has been used recently.
OBJECTIVE: To evaluate the clinical effects of anterior versus posterior C2-3 pedicle screws on Hangman’s fracture.
METHODS: Twenty-six patients with Hangman’s fracture were randomized into two groups, treated with anterior decompression bone fusion plus titanium plate implantation or posterior C2 pedicle screw plus C3 lateral mass screw-rod implantation.
RESULTS AND CONCLUSION: The operation time, intraoperative bleeding and postoperative drainage were shorter or less in anterior cervical operation as compared with in posterior cervical operation (P < 0.05). There were no differences in intraoperative and postoperative complications between the two groups. The results demonstrated that C2-3 anterior fusion and plate fixation is a better method to treat Hangman’s fracture, maintaining excellent reduction and achieving stability, compared with C2-3 posterior pedicle screws fixation.

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